Moderate Microtia

Abstract

Each patient requires meticulous preoperative evaluation to choose the proper surgical technique in reconstruction of the auricle for moderate microtia. One must perform a cartilaginous graft excavated on a block of rib cartilage in most patients because the auricular cartilage skeleton is lacking in all of them. The new framework must be created according to the missing segment of the congenital anomaly. Surgical planning must be performed to provide an adequate place to embed the new auricular skeleton in proper balance with the opposite side when in a normal position. However, in bilateral abnormalities, the surgical planning of reconstruction depends on the surgeon’s creativity. The reconstruction procedure is performed in two surgical stages. Most patients with moderate ectopic microtia present with associated anomalies and always have accentuated inclination of the external auditory meatus. Therefore, the second stage of reconstruction is much more complex, as the remaining segment of the auricular deformity must be lifted upward. Usually, patients with moderate eutopic microtia present with an excessive cutaneous covering on the posterior aspect of the remnant segment of the congenital anomaly. Quite often, rotation of this segment provides adequate skin covering for the entire surface of the posterior aspect during the second stage of ear reconstruction. When necessary, a skin graft may be performed to reshape the posterior ear surface.